KELLY O SMITH (PA) – Physician Assistant, NPI 1851689467

KELLY O SMITH (PA) is a healthcare provider. based in Bloomfield, Connecticut. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 002588 (CT). The NPI Number for KELLY O SMITH (PA) is 1851689467

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
KELLY O SMITH (PA)
NPI
1851689467
Phone
(860) 243-3020
Address
47 JOLLEY DR
Enumeration Date
16 July 2011
Last Update Date
23 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2011 (15 years ago)
PAC ID
3678743010
Group Practice PAC ID
5092706945
Professional Enrollment ID
I20110823000394
Address ID
CT063607403NO111XXTURN301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:14State licenses:1Digital endpointsOther names

3,243 PHYSICIAN ASSISTANT in CT

Provider Addresses for KELLY O SMITH (PA)

  • 47 JOLLEY DR

    BLOOMFIELD, CT 060023092

    Phone: (860) 243-3020

    Fax: (860) 243-3002

    Type: Mailing

  • 111 SALEM TPKE STE 7

    NORWICH, CT 063607403

    Phone: (860) 859-2262

    Fax: (860) 859-9819

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 81 Open Payments records for all available years, with a total value of $1,768.

Total Amount is formed as General ($1,768) + Research ($0) + Ownership ($0) = $1,768.

Last reported payment date: 2024-12-18 • Largest payer in this snapshot: ABBVIE INC. ($591).

Total Amount

$1,768

General + Research + Ownership

Payments

81

Total payment records

General Amount

$1,768

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-08-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110823000394IPhysician AssistantCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths8524$0
99213Established patient office or other outpatient visit, 20-29 minutes7560$0
99203New patient office or other outpatient visit, 30-44 minutes6161$0
17000Destruction of precancer skin growth, 1 growth5041$0
11102Biopsy of related skin growth, first growth4240$0
View full utilization report →

Insurance plans in this area (ZIP 06002)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5092706945View full group profile
NameSpecialtyState
Physician AssistantCT
Physician AssistantCT
Nurse PractitionerCT
D E R M A T O L O G YCT
D E R M A T O L O G YPA
D E R M A T O L O G YCT
D E R M A T O L O G YVT

Reviews

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Frequently asked questions

What unique ID ties claims to KELLY O SMITH (PA)?
NPI 1851689467 is assigned to KELLY O SMITH (PA) under the national enumeration system.
Does this profile mean KELLY O SMITH (PA) is currently active?
Yes — KELLY O SMITH (PA) appears active in the national provider directory.
What field does KELLY O SMITH (PA) work in?
You can think of KELLY O SMITH (PA) as practicing within Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is KELLY O SMITH (PA)'s primary listing?
We display Bloomfield, Connecticut because that is what the record indicates for KELLY O SMITH (PA).
How can I contact KELLY O SMITH (PA)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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